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目的 比较大肠癌术后单用 5 Fu及联合应用 5 Fu、顺铂及丝裂霉素行腹腔化疗 (in traperitonealchemotherapy,IPC)的疗效及并发症。方法 5 2例大肠癌术后分为 5 Fu组 (32例 )及联合组 (2 0例 )。术后 2周行IPC ,比较两组腹腔癌肿复发率 ,种植灶治愈率及毒副作用发生率的差异。结果 ① 5 Fu组的DukesC1期患者腹腔癌肿复发率为 5 8 3% ,显著高于联合组的C1期 (无 1例复发 ) ,P <0 0 1。联合组 5例D期患者 ,3例再次手术证实腹腔内原种植灶全部消失 ;②联合组的粘连性肠梗阻发生率为 2 5 0 %、化学性腹膜炎为 40 0 %及胃肠反应率 5 0 0 % ,均分别显著高于 5 Fu组的3 1% (P <0 0 5 )、9 3 % (P <0 0 5 )及 3 1% (P <0 0 1) ;③两组共 6例粘连性肠梗阻 (5 Fu组 1例 ,联合组 5例 ) ,术中发现其粘连呈腹茧症表现 ,行肠排列术后治愈。结论 联合组的IPC疗效及粘连性肠梗阻发生率均显著高于 5 Fu组
Objective To compare the efficacy and complications of single-use 5 Fu and combined use of 5 Fu, cisplatin and mitomycin in intratrapulmonary chemotherapy (IPC) after colorectal cancer. Methods 52 patients with colorectal cancer were divided into 5 Fu group (32 cases) and combined group (20 cases). IPC was performed 2 weeks after surgery. The recurrence rate of cancer in the abdominal cavity, the cure rate of the implanted tumor and the incidence of toxic and side effects were compared between the two groups. Results The recurrence rate of cancer in the abdominal cavity of Dukes C1 stage patients in the 5 Fu group was 583%, which was significantly higher than that of the combined group in the C1 phase (none of the recurrences). P <0 01. In the combined group of 5 patients with stage D, 3 cases had re-operation confirmed that the original intra-abdominal implanted lesions disappeared; 2 the incidence of adhesive intestinal obstruction in the combined group was 25%, chemical peritonitis was 40%, and the gastrointestinal response rate was 50%. 0% were significantly higher than 3 1% (P <0 0 5), 9 3% (P <0 05), and 3 1% (P <0 01) in the 5 Fu group; 3 groups were 6 Adhesive intestinal obstruction (1 case in the 5 Fu group and 5 cases in the combined group) was found during the operation. The adhesions were abdominal hernia symptoms and were cured after bowel alignment. Conclusions The IPC efficacy and the incidence of adhesive intestinal obstruction in the combined group were significantly higher than those in the 5 Fu group.